Caljeb Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

016177 Issued in NY

Legal business name

CALJEB PHARMACY CORP

Practice address

747 Montauk Highway
Patchogue, NY 11772

Phone

(631) 654-2444

Fax

(631) 654-1837

NPI assigned

May 27, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patrick Fawcett, MBA

Title

Ceo

Phone

(631) 654-2444

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• LIGHTHOUSE PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1275536864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 MONTAUK HIGHWAY",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-654-2444",
            "fax_number": "631-654-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 MONTAUK HIGHWAY",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-654-2444",
            "fax_number": "631-654-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALJEB PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-654-2444",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "016177",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00628717",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2060288",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIGHTHOUSE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roberto R Cabral
• Lina Cabrera
• Normil RJ Cadet
• Joanne Cady
• Lisa Caliguri, M.A./SLP-CCC; TSLD
• Alicia Camacho, M.D.
• Dax Christopher Campbell, PT
• Gustavo A. Cardenas, M.D.
• Cardio Thoracic & Vascular Surgery PC
• Cardone Family Optometry, PLLC

• Community/Retail Pharmacy in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.